By Suresh Perera
The death of 20 babies at the Mahamodara Teaching Hospital during the past three months has brought into focus the incredibly shocking parlous state of this maternity and childcare tertiary level state medical facility in the South and the lack of vital, life-saving medical supplies, which had exacerbated the frustrating situation, officials said last week.
Four infants had died due to a bacterial infection in the Special Care Baby Unit (SCBU) housed in a dilapidated building which faces the threat of imminent collapse. In the past two months alone, an electrical short circuit had caused a fire, which was fortunately brought under control with no loss to life or property, they pointed out.
In January 2012, six babies died, in February 10 and in March four so far. Eleven babies were infected with the Kledsiella bacteria, but only four had died. (The lives of the other seven children were saved due specialist medical care). Nine children had died during this period due to low birth weight, prematurity and congenital abnormalities, medical sources said.
The Mahamodara hospital was battered by the 2004 tsunami totally wiping out some of the buildings. What remained of the complex was condemned and declared unfit and unsafe for human occupation. This saw the hospital being temporarily shifted to Karapitiya. However, in a move which defied belief, it was later decided to re-house this medical facility in the ‘touched up’ damaged buildings within its original premises, the officials recalled.
With more than 15,000 deliveries per annum (An average of 1,200 per month), this hospital is ranked amongst the key maternity and childcare facilities in Sri Lanka. But, in addition to being housed in a run-down, condemned building, it is also faced with a critical shortage of nursing staff. This meant that there are only five to six nurses per shift to treat 25 babies, while the normal ratio for an intensive care unit such as the SCBU is 1:1, they said.
The SCBU remains closed for new admissions pending a complete infection control process.
Due to inadequacy of space, there is heavy congestion with two to three mothers with their babies sharing a single hospital bed. Sometimes two beds are combined and shared by four mothers with their babies. This unhealthy practice had raised concerns over infections but what was the alternative?", they asked.
Reports of the deaths surfaced on March 1, but it was only nine days later two senior health administrators, Dr. Palitha Maheepala and Dr. Ajith Mendis were sent to get a first-hand account. This was after the issue was raised in Parliament by the Opposition with Minister Sirisena expected to meet the media this week. Earlier, a team of microbiologists was dispatched to the hospital, officials asserted.
The Professorial Unit of the Karapitiya Medical Faculty led by Prof. Malik Gunawardena, a senior eminent gynaecologist and obstetrician and other specialists had continuously pushed the Health Ministry to develop this hospital with a serious approach within an early timeframe or face grave consequences, the officials said. "That’s exactly what we are grappling with today".
Aggravating the situation was the non-availability of life-saving medical supplies at this hospital. For the past few months, there had been no sterile syringes (Especially the 1 ml size used mainly for babies), sterile gloves, Endotracheal Tubes (ET tubes — a device used to connect babies to an artificial ventilator), paediatric cannulas (A device used to give injections and saline to babies) and other vital needs such as CVP lines, sutures and bandages, the officials explained.
Even chemicals used for infection control are not adequately provided, they asserted. "When there is something amiss, those in authority talk as if global standards were maintained".
What sterility can be expected under these circumstances?, they asked. "When there are deaths, so-called inquiries are conducted but the causes and contributory factors remain intact".
As reported in The Sunday Island recently, medical supplies to government hospitals have been disrupted due to alleged meddling in tenders by politically powerful persons keen to make big bucks.
While the infant mortality rate in the country is 11 per 100,000 live births, Mahamodara hospital has recorded a high rate of 20/2,500 live births so far this year, the officials said.
Sri Lanka has continued to maintain remarkably low maternity and infant mortality rates – one of the best in Asia. But, with the disturbing turnaround under the present set-up, the country faces the prospect of losing this coveted position, they warned.
With the retirement of Dr. Nanda Waduge, Mahamodara hospital’s director, on February 16, 2012, deputy director, Dr. Rukshan Bellana was placed in an acting capacity. With news of the deaths surfacing, Dr. Bellana, who had taken over as the acting boss just a fortnight ago, immediately became the "fall guy", medical officials pointed out.`
The Health Ministry, eager to tide over the bad press, was on the lookout for a "whipping boy" and pounced on Dr. Bellana and an official news release declared that he had been "removed". In actual fact, with Dr. Priyani Senadheera taking over as director on Monday on an annual transfer, the acting director reverted to his substantive post as the deputy, they noted.
"It was clearly an attempt to cover up the grave lapses and "satisfy" those calling for the Ministry to put its house in order that Dr. Bellana was "removed" when, on the other hand, he still continues to serve in his capacity as deputy director", they asserted.
"When a director retires, the Ministry drags its feet in appointing a successor and this leads to the deputy being placed on an acting capacity", says Dr. Jayantha Bandara, national organizer, Senaka Bibile Memorial Association and organizing secretary, All Ceylon Government Medical Officers’ Association (ACGMOA).
When there is an issue, a big noise is made about ‘investigations’ and ‘removals’, but it is mere eye wash, he charged. "Ultimately, all this din boils down to nothing as the whole objective is to mislead the people".
He said that when objections are raised against the import of substandard drugs, the Ministry flatly denies it and if there is a rumpus following a death, appoints its own people to "probe" the allegations. In the end, it is all swept under the carpet because they don’t want to make adverse comments and go against the Minister. "This is ridiculous".
"The Minister had offered to resign if allegations on substandard drugs can be proven. How can this be proven for him to step down when the National Drugs Quality Assurance Laboratory – the authority entrusted with this task – is also under the Minister himself?", he asked.
Dr. Bandara said that former German Chancellor Helmut Kohl, who was rescued during the tsunami, pledged funds to rebuild the Mahamodara hospital. Subsequently, in 2005 the Helmut Kohl Foundation in Germany had sent Rs. 3.3 billion via the then German Ambassador to put up a six-storied building.
However, the job didn’t proceed beyond the foundation, he said. "Eight years had gone by, but nothing happened despite the availability of such an enormous quantum of funds".
The Helmut Kohl Foundation had started construction work in collaboration with a private contractor, a Health Ministry official said. "The money didn’t come to the government though a state land was allocated for the purpose".
Ultimately, the contractor pulled out as the required funds to continue the project were not forthcoming, he noted. "That brought the whole process to a grinding halt".
The government has an obligation to tell the country what happened to the billions of rupees given for this specific purpose, Bandara said. "The land and the design for the proposed complex came from the Ministry. So surely, it could not have been in total darkness".
http://www.island.lk/index.php?page_cat=article-details&page=article-details&code_title=47162
The death of 20 babies at the Mahamodara Teaching Hospital during the past three months has brought into focus the incredibly shocking parlous state of this maternity and childcare tertiary level state medical facility in the South and the lack of vital, life-saving medical supplies, which had exacerbated the frustrating situation, officials said last week.
Four infants had died due to a bacterial infection in the Special Care Baby Unit (SCBU) housed in a dilapidated building which faces the threat of imminent collapse. In the past two months alone, an electrical short circuit had caused a fire, which was fortunately brought under control with no loss to life or property, they pointed out.
In January 2012, six babies died, in February 10 and in March four so far. Eleven babies were infected with the Kledsiella bacteria, but only four had died. (The lives of the other seven children were saved due specialist medical care). Nine children had died during this period due to low birth weight, prematurity and congenital abnormalities, medical sources said.
The Mahamodara hospital was battered by the 2004 tsunami totally wiping out some of the buildings. What remained of the complex was condemned and declared unfit and unsafe for human occupation. This saw the hospital being temporarily shifted to Karapitiya. However, in a move which defied belief, it was later decided to re-house this medical facility in the ‘touched up’ damaged buildings within its original premises, the officials recalled.
With more than 15,000 deliveries per annum (An average of 1,200 per month), this hospital is ranked amongst the key maternity and childcare facilities in Sri Lanka. But, in addition to being housed in a run-down, condemned building, it is also faced with a critical shortage of nursing staff. This meant that there are only five to six nurses per shift to treat 25 babies, while the normal ratio for an intensive care unit such as the SCBU is 1:1, they said.
The SCBU remains closed for new admissions pending a complete infection control process.
Due to inadequacy of space, there is heavy congestion with two to three mothers with their babies sharing a single hospital bed. Sometimes two beds are combined and shared by four mothers with their babies. This unhealthy practice had raised concerns over infections but what was the alternative?", they asked.
Reports of the deaths surfaced on March 1, but it was only nine days later two senior health administrators, Dr. Palitha Maheepala and Dr. Ajith Mendis were sent to get a first-hand account. This was after the issue was raised in Parliament by the Opposition with Minister Sirisena expected to meet the media this week. Earlier, a team of microbiologists was dispatched to the hospital, officials asserted.
The Professorial Unit of the Karapitiya Medical Faculty led by Prof. Malik Gunawardena, a senior eminent gynaecologist and obstetrician and other specialists had continuously pushed the Health Ministry to develop this hospital with a serious approach within an early timeframe or face grave consequences, the officials said. "That’s exactly what we are grappling with today".
Aggravating the situation was the non-availability of life-saving medical supplies at this hospital. For the past few months, there had been no sterile syringes (Especially the 1 ml size used mainly for babies), sterile gloves, Endotracheal Tubes (ET tubes — a device used to connect babies to an artificial ventilator), paediatric cannulas (A device used to give injections and saline to babies) and other vital needs such as CVP lines, sutures and bandages, the officials explained.
Even chemicals used for infection control are not adequately provided, they asserted. "When there is something amiss, those in authority talk as if global standards were maintained".
What sterility can be expected under these circumstances?, they asked. "When there are deaths, so-called inquiries are conducted but the causes and contributory factors remain intact".
As reported in The Sunday Island recently, medical supplies to government hospitals have been disrupted due to alleged meddling in tenders by politically powerful persons keen to make big bucks.
While the infant mortality rate in the country is 11 per 100,000 live births, Mahamodara hospital has recorded a high rate of 20/2,500 live births so far this year, the officials said.
Sri Lanka has continued to maintain remarkably low maternity and infant mortality rates – one of the best in Asia. But, with the disturbing turnaround under the present set-up, the country faces the prospect of losing this coveted position, they warned.
With the retirement of Dr. Nanda Waduge, Mahamodara hospital’s director, on February 16, 2012, deputy director, Dr. Rukshan Bellana was placed in an acting capacity. With news of the deaths surfacing, Dr. Bellana, who had taken over as the acting boss just a fortnight ago, immediately became the "fall guy", medical officials pointed out.`
The Health Ministry, eager to tide over the bad press, was on the lookout for a "whipping boy" and pounced on Dr. Bellana and an official news release declared that he had been "removed". In actual fact, with Dr. Priyani Senadheera taking over as director on Monday on an annual transfer, the acting director reverted to his substantive post as the deputy, they noted.
"It was clearly an attempt to cover up the grave lapses and "satisfy" those calling for the Ministry to put its house in order that Dr. Bellana was "removed" when, on the other hand, he still continues to serve in his capacity as deputy director", they asserted.
"When a director retires, the Ministry drags its feet in appointing a successor and this leads to the deputy being placed on an acting capacity", says Dr. Jayantha Bandara, national organizer, Senaka Bibile Memorial Association and organizing secretary, All Ceylon Government Medical Officers’ Association (ACGMOA).
When there is an issue, a big noise is made about ‘investigations’ and ‘removals’, but it is mere eye wash, he charged. "Ultimately, all this din boils down to nothing as the whole objective is to mislead the people".
He said that when objections are raised against the import of substandard drugs, the Ministry flatly denies it and if there is a rumpus following a death, appoints its own people to "probe" the allegations. In the end, it is all swept under the carpet because they don’t want to make adverse comments and go against the Minister. "This is ridiculous".
"The Minister had offered to resign if allegations on substandard drugs can be proven. How can this be proven for him to step down when the National Drugs Quality Assurance Laboratory – the authority entrusted with this task – is also under the Minister himself?", he asked.
Dr. Bandara said that former German Chancellor Helmut Kohl, who was rescued during the tsunami, pledged funds to rebuild the Mahamodara hospital. Subsequently, in 2005 the Helmut Kohl Foundation in Germany had sent Rs. 3.3 billion via the then German Ambassador to put up a six-storied building.
However, the job didn’t proceed beyond the foundation, he said. "Eight years had gone by, but nothing happened despite the availability of such an enormous quantum of funds".
The Helmut Kohl Foundation had started construction work in collaboration with a private contractor, a Health Ministry official said. "The money didn’t come to the government though a state land was allocated for the purpose".
Ultimately, the contractor pulled out as the required funds to continue the project were not forthcoming, he noted. "That brought the whole process to a grinding halt".
The government has an obligation to tell the country what happened to the billions of rupees given for this specific purpose, Bandara said. "The land and the design for the proposed complex came from the Ministry. So surely, it could not have been in total darkness".
http://www.island.lk/index.php?page_cat=article-details&page=article-details&code_title=47162
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